Critical Path Network: Dashboard helps hospitals focus on core measures
Critical Path Network
Dashboard helps hospitals focus on core measures
Green, yellow, red designate performance
A color-coded performance-tracking dashboard posted in strategic locations helps clinicians at INTEGRIS Rural Health’s hospitals stay focused on the core measures of the Centers for Medicare & Medicaid Services (CMS).
The dashboard is created quarterly, using data that are sent to CMS. It lists each individual measure, with the hospital’s performance on that measure represented by a color code, says Denise Caram, MS, CPUM, CPUR, director of support services for the Oklahoma City-based eight-hospital system.
"It shows me by hospital and by system how well we are doing," Caram says. "If a hospital is doing well on that particular measure, it’s green; if a little improvement is needed, it’s yellow; if they need a lot of improvement, it’s red."
The case managers are deeply involved in improving performance on the core measures, Caram says.
When the hospital system first looked at compliance with the core measure targets, the administrators drilled down to find out why some hospitals did well and others did not do so well.
"In the hospitals that were very successful at meeting the core measures, the case managers were heavily involved in compliance activities. It was an eye-opener for all of us," Caram says.
When the hospital system implemented its physician-aligned case management model in early 2000, the case managers worked with physicians to develop order sets for the top DRGs, based on evidence-based guidelines.
Those order sets became a guide for case managers who review the patient chart and make sure the recommended care is followed and documented. For instance, the order sets required that pneumonia patients receive antibiotics within two hours of admission.
The process paved the way for the hospital system’s compliance efforts when CMS implemented the core measures performance measurement system.
The corporate quality department developed the dashboard as a way to easily demonstrate how each hospital is doing on each of the core measures and how the system is performing overall. The case managers are closely involved in gathering the information.
"Each quarter, the dashboard makes it easy for people to know where to focus," she adds.
The dashboard is posted in prominent places around the hospital and on INTEGRIS Healthcare’s web site.
"If the hospital isn’t 100% compliant, this gives them an indication of where things need to improve. They can go back and do a chart review and drill down to find the reasons," she says.
When they review the charts, the case managers use a "cheat sheet" listing recognized standards of care for each DRG. They check to make sure that everything indicated for the patient has been done and has been documented in the chart. If the care mandated on the order set for that DRG isn’t being implemented, the case manager checks with the attending physician to find out why.
The hospital system’s administration takes compliance with the core measures seriously, Caram says.
"The dashboard is driven by the quality director in each facility, and they have had an excellent partnership with the case management department. Even when change is hard, we all have to be change agents. At our hospital system, it’s been a continuous learning process, with all disciplines involved," she adds.
A color-coded performance-tracking dashboard posted in strategic locations helps clinicians at INTEGRIS Rural Healths hospitals stay focused on the core measures of the Centers for Medicare & Medicaid Services (CMS).Subscribe Now for Access
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